Life-changing surgery for spina bifida now available in St. Louis

Doctors in the operating room during an in utero surgery (Credit: KMOV)

ST. LOUIS, Mo. (KMOV.com) -

For the first time at Barnes-Jewish Hospital, a team of experts completed an in utero surgery on a baby with spina bifida.

Earlier this month, physicians with Barnes-Jewish and St. Louis Children’s Hospital created one of the hospitals’ biggest medical teams including specialists in neonatology, neurology, cardiology, material fetal medicine, pharmacy, and anesthesiology to carry out the surgery.

“This surgery has really changed the concept of fetal surgery,” said Dr. Michael Bebbington, director of the Fetal Care Center of Barnes-Jewish Hospital, St. Louis Children’s Hospital (SLCH) and Washington University. “In the past, we only did fetal surgery in the situation that if we didn’t do something the baby would die. But now what we are basically doing is changing the life course of this child.”

That held true in the case of the 25-week old fetus the team operated on earlier in October.

“The abnormality for this baby was such that it would have affected its ability to stand and walk and now the hope is this will be a baby that will be able to walk independently,” said Dr. Bebbington.

When a baby, like the one he recently operated on, has spina bifida, the bones and skin around the lower part of the back don’t fully form in the womb. The spine is exposed to the amniotic fluid in utero and that causes significant nerve damage. So, the sooner the hole can be closed, the less damage. Still, the timeline is sensitive because the fetus has to be far enough along that the tissue can handle the procedure, but also not too close to birth because it needs time in the womb to heal and realize the full benefits of the surgery.

This family from Columbia, Missouri was an ideal candidate for the surgery, with both mom and baby being in good health. Still, the surgery takes a toll on the whole family because mom is on bed rest for weeks to come and needs to be nearby her medical team in case of an emergency. That is one reason is it so significant that this in utero surgery is now available at Barnes-Jewish.

“It’s a great stride forward for families in St. Louis but also in the Midwest because we are the only place in the Midwest that’s offering this type of surgery,” said Dr. Bebbington.

On average, 1,500 babies are born each year with spina bifida but Dr. Bebbington says for every five to six families evaluated for the surgery, usually only one will qualify. He explained some families decide it’s not worth the risk and in other cases, for example, is the lesion is too low on the spine, the surgery may not offer enough benefits.

“It never ceases to amaze me what mothers will do to try and give their children every benefit in life and the moms undertake a lot of risk to have this kind of surgery,” said Dr. Bebbington.

While the surgery has been done before in St. Louis at Cardinal Glennon, currently, Barnes-Jewish Hospital, along with medical experts from St. Louis Children’s Hospital, is the only local medical facility that offers it. Dr. Bebbington has previously done the surgery in Philadelphia and Houston but his move to St. Louis helps expand fetal care opportunities in the Midwest.